The surgical treatment of superficial thrombophlebitis

Abstract

Of 3,941 patients who underwent varicose vein surgery from 1968 through 1978, 163 had superficial thrombophlebitis, a common complication of varicose veins. Superficial thrombophlebitis was more frequently found in the older age groups. The incidence of occurrence (three women to one man) was identical to that of the overall group operated on for varicose veins. Twenty-two percent of the patients had thrombophlebitis that extended into the saphenous vein at or near the saphenofemoral juncture. Superficial thrombophlebitis was more frequently located in the varicosities below the knee instead of above the knee. The prolonged duration of superficial thrombophlebitis and the recurrent attacks suggest that thrombophlebitis can be chronic, recurrent, or subacute and may remain a threat as long as the varicosities are present. Review of these 163 patients, 161 of whom have been followed up from 1 to 12 years (average 5 years), who were consecutively treated by surgical excision of the thrombosed segments, with excision or stripping of the remaining varicosities, underscores the clinical impression that the surgical removal of the thrombosed vein segments and the associated varicosities shortens the convalescence and mitigates against later recurrence. This form of treatment was accomplished without death or significant morbidity, except for two patients who had clinical suspect nonfatal minor pulmonary emboli during the postoperative hospital period. Prophylactic anticoagulants were used in most patients. Surgical removal of the varicosities with excision of the thrombosed veins is currently our preferred treatment for superficial thrombophlebitis in otherwise healthy patients.